对心房功能性 mitra 反的定性和定量评估:来自 REVEAL-AFMR 注册表的分析
Azusa Murata1, Tomohiro Kaneko1, Masashi Amano2
1Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
European heart journal. Cardiovascular Imaging
|November 8, 2024
概括
严重的心房功能性心肌反 (AFMR) 是常见的,并与更糟糕的结果相关. 有效吐孔面积 (EROA) 和吐体积的定量值有助于指导AFMR的治疗决策.
科学领域:
- 心脏病学 心脏病学
- 心血管成像 - 心血管成像
- 临床医学 临床医学
背景情况:
- 目前尚不清楚心房功能性心肌反 (AFMR) 的严重程度及其预后影响.
- 有效吐孔面积 (EROA) 和吐体积等定量指标在AFMR中没有被系统地评估.
- 这项研究解决了关于AFMR严重性评估及其临床影响的缺乏明确性.
研究的目的:
- 根据严重程度确定AFMR的患病率,特征和预后.
- 评估AFMR严重性的定性和定量评估的临床影响.
- 确定AFMR严重性及其与患者结果的关联的定量值.
主要方法:
- 对1007名患有至少中度AFMR的患者进行了多中心追溯分析.
- 使用综合方法评估AFMR的严重程度,包括EROA,反体积和反分数.
- 使用Cox比例危险模型分析了AFMR严重程度与不良事件的独立关联.
主要成果:
- 72.3%的人有中度,14.5%的中度至重度,13.2%的重度AFMR.
- 严重的AFMR与较长的心房动史,更严重的心力衰竭症状和更大的心室有关.
- AFMR的严重程度独立预测死亡风险增加,心力衰竭住院和心心干预 (严重AFMR的HR为2.80).
- 定量值 (EROA≥0.30厘米2,吐剂体积≥60毫升,吐剂分数≥50%) 表明事件风险明显更高.
结论:
- 严重的AFMR是普遍存在的,并且与心房的增加负担和心脏结构异常有关.
- 对AFMR严重性的定量值为临床决策和治疗规划提供了有价值的指导.
- 这项研究强调了AFMR严重程度的预后意义以及定量措施在患者管理中的有用性.
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